Ch 16-19

Question 1

What are the 6 steps for administering the Heimlich maneuver?

Answer 1

Tell the person what you are about to do
Place arms around the victim’s waist from behind
Thumb goes on the outside of your fist
Place the fist on the abdomen just below the sternum
With the other hand, grasp your wrist
Quickly and forcibly, apply pressure upward against the diaphragm just below the ribs

Question 2

How is the Heimlich maneuver done on an infant (6 steps)?

Answer 2

Turn the infant prone with their head lower than their feet
Support head by firmly holding the jaw
Deliver up to 5 forceful back blows between the shoulder blade with the heel of the hand
While supporting the head and neck, turn the infant over with the head lower than the torso
Place 2 middle fingers on the sternum just below the nipple line
Administer 5 thrusts over the sternum, taking care not to press over the liver

Question 3

Difficulty breathing caused by bronchospasm, sometimes related to allergies and precipitated by stress

Answer 3

Asthma

Question 4

What are 3 treatment methods for asthma?

Answer 4

Administering oxygen to keep the O2 level above 92%
Administration of albuterol by inhaler or nebulizer
Subcutaneous epinephrine injection

Question 5

An embolus travels through the vascular system and becomes lodged in a pulmonary vessel

Answer 5

Pulmonary Embolism (PE)

Question 6

What imaging modalities did we discuss in class that can be used to diagnose a pulmonary embolism?

Answer 6

Imaging such as chest x-rays or CT angiography

Question 7

What treatment methods are used for pulmonary embolisms?

Answer 7

Anticoagulants, oxygen and pain relief medications or surgery in severe cases

Question 8

Insufficient blood supply to the heart muscle

Answer 8

Ischemia

Question 9

Medical term for a heart attack; a coronary artery is blocked and part of the heart wall becomes ischemic

Answer 9

Myocardial infarction

Question 10

What may be some warning signs of myocardial infarction

Answer 10

Pain in the left arm, jaw or neck, diaphoresis, irregular heartbeat, pallor, nausea or SOB

Question 11

Chest pain, when the coronary arteries fail to supply enough oxygen to the heart

Answer 11

Angina pectoris

Question 12

What common medications are given for angina pectoris?

Answer 12

Nitroglycerin

Question 13

Where is the medication for angina pectoris administered?

Answer 13

Sublingual

Question 14

What is a defibrillator?

Answer 14

Administers an electric shock to correct an ineffectual cardiac rhythm
Two paddles attached to the machine make contact with the patient’s chest
Once in place, the paddles can take a quick analysis for normal cardiac rhythm
A shock is then delivered after all staff is clear of danger

Question 15

What does CPR stand for and what is the purpose?

Answer 15

Cardiopulmonary resuscitation; basic life support system to ventilate the lungs and circulate the blood during respiratory or cardiac arrest

Question 16

How often will you be required to renew your CPR license?

Answer 16

All RTs will be CPR certified and will update those skills about every 2 years

Question 17

Damage to the brain caused by violent jarring or shaking

Answer 17

Concussion

Question 18

What are 6 signs of a concussion?

Answer 18

Irritability, lethargy, slowing pulse and respiration, seizure, loss of consciousness or respiratory arrest

Question 19

When someone has an injury where they may be at risk of a spinal cord injury, what precautions are taken to ensure the patient is not further injured?

Answer 19

Patients are transported on a rigid backboard to prevent hazardous movement

Question 20

Blood in the pleural space

Answer 20

Hemothorax

Question 21

Air in the pleural space

Answer 21

Pneumothorax

Question 22

Removal of fluid from the pleural space

Answer 22

Thoracentesis

Question 23

Splintered bones are forced through the skin

Answer 23

Compound fracture

Question 24

What 3 things are done in the ED for a compound fracture before the patient is transported elsewhere?

Answer 24

Compound fractures are partially reduced and a dressing is applied before radiography
Temporary immobilization is also done with a rigid object
Observe the patient for impaired circulation: fingers and toes should be warm, pink and sensitive to touch and pressure

Question 25

4 burn levels

Answer 25

Epidermis only Dermal layer Extends subcutaneously Skin, fat, muscle and sometimes bone

Question 26

General term to describe circulation failure where blood pressure is inadequate to support oxygen perfusion of vital tissue

Answer 26

Shock

Question 27

5 types of shock and their characteristics

Answer 27

Hypovolemic- low blood volume occurs when a large amount of blood or plasma has been lost resulting in an insufficient blood supply to the circulatory system Septic- massive infections produce toxins that cause increased capillary permeability and vasodilation, resulting in low blood pressure Neurogenic- failure of arterial resistance causes a pooling of blood in peripheral vessels Cardiogenic- results from cardiac failure or interferes with heart function Allergic- individuals are exposed to substances to which they are sensitized

Question 28

What are the 7 signs and symptoms of shock?

Answer 28

Restlessness and sense of apprehension Increased pulse rate Pallor with weakness and change in thinking ability Cool, clammy skin Fall in BP: 30mm below baseline systolic pressure Decreased urination Increased and shallow respiration

Question 29

Syncope

Answer 29

Fainting

Question 30

Erythemea

Answer 30

Skin reddening

Question 31

Urticaria

Answer 31

Hives

Question 32

Insulin dependent; individuals little or no insulin Insulin is administered parenterally Prominent in individuals under age 25

Answer 32

Type I diabetes

Question 33

Occurs in obese individuals over age 40 with a marked family tendency Responds to oral hypoglycemic meds and changes to diet and lifestyle

Answer 33

Type II diabetes

Question 34

Stroke, an interruption of blood supply to the brain | Cerebrovascular accident

Answer 34

CVA

Question 35

2 types of CVAs

Answer 35

Hemorrhagic | Ischemic

Question 36

Cerebral artery is ruptured and blood leaks into brain tissue

Answer 36

Hemorrhagic

Question 37

A blood clot in a cerebral artery cause a loss of blood supply to brain tissue

Answer 37

Ischemic

Question 38

What are the 6 signs and symptoms of CVAs?

Answer 38

``` Slurred or difficult speech Extreme dizziness Severe headaches Muscle weakness on one or both slides Difficulty in vision Temporary loss of consciousness ```

Question 39

What is orthostatic hypotension and what causes it?

Answer 39

Common after prolonged bed rest | Blood pools in extremities when the torso is elevated, causing cerebral anoxia (lack of oxygen)

Question 40

The patient is ‘spinning’ | May be nauseated

Answer 40

Vertigo

Question 41

Epistaxis

Answer 41

Nosebleed

Question 42

3 types of contrast media

Answer 42

Barium sulfate Water soluble Iodine compounds and gases

Question 43

What is the sequence (5) for scheduling diagnostic studies according to the book? Also using what you know about radiographic principles, describe why each one is in this particular order in relation to what is follows and proceeds

Answer 43

All radiographic exams not requiring contrast media and any lab studies for iodine uptake: without contrast media no other examinations will be affected Radiographic exams of the urinary tract: with normal kidney function the iodine contrast is cleared and disappears Radiographic exams of the biliary system: uses injections of contrast media under fluoroscopy Lower gastrointestinal series (barium enema): because a barium enema is used to clean the large intestine which requires several steps Upper gastrointestinal series: because it usually results in barium scattered throughout the intestinal tract

Question 44

What are preparation methods for lower GI studies?

Answer 44

Includes use of cathartics, suppositories or enemas, as well as diet

Question 45

What are diet exam preparations?

Answer 45

Patients placed on low residue diets for several days before examination Liquid intake is encouraged to evacuate the bowel 24 hours before exam the patient may restricted to clear liquids (includes apple juice, gelatin and tea) Fasting; NPO 8-12 hours before the procedure

Question 46

Why are diet preparations ordered and how does it enhance the study if the patient is NPO?

Answer 46

Fasting ensures the stomach is empty during examination for 2 reasons: the stomach is empty and clean, it will produce accuracy of the inner surfaces Examination can cause nausea, so the patient is less likely to vomit

Question 47

Strong laxative preparation for bowel cleansing

Answer 47

Cathartics

Question 48

The colon is filled with liquid to dislodge and flush out feces Nursing carries out this task for inpatients Equipment: enema bag, attached tubing, disposable rectal catheter and an IV pole to suspend the enema bag. Liquid used: tap water or soapsuds in water Tap water enema – 1050F water

Answer 48

Cleansing enema

Question 49

Why would you use iodinated contrast media for a GI study instead of Barium?

Answer 49

Iodine contrast can be absorbed by the bloodstream if there's a rupture of the GI tract

Question 50

Compare & contrast using barium vs. iodine contrast (what are their strengths & weaknesses)?

Answer 50

Barium can be administered orally or rectally, can be made into thick or thin consistencies and its tasteless but can be difficult to swallow due to its chalky consistency and it absorbs water and can solidify like plaster. Iodine is water soluble and can be absorbed by the bloodstream but they're more expensive and less radiopaque

Question 51

Why would you never use barium contrast outside of the GI tract?

Answer 51

It can't be absorbed by the bloodstream

Question 52

What does air contrast look like when it shows up on a radiograph?

Answer 52

Dark or black

Question 53

Taken before contrast administration | Can provide information that proper preparation was performed

Answer 53

"Scout" image

Question 54

8 steps for a barium enema

Answer 54

Place the patient in the lateral recumbent position or the left Sims’ position Insert the lubricated tip If a retention catheter is used, inflate the cuff After the tip is inserted, rotate the patient to the supine position The radiologist will indicate when to start and stop barium flow After fluoroscopy, routine radiographs are used After the study, take the bag off the IV pole and let the barium drain back into the reservoir bag escort the patient to the bathroom If post-evacuation images are needed, ensure the patient has evacuated their colon as well as possible

Question 55

What are ostomies?

Answer 55

Colostomies or ileostomies are surgical resections where the distal end of the bowel terminates in an artificial opening Can be temporary or permanent Special catheters are used for colostomy BEs. A urinary catheter may be used due to its smaller size.

Question 56

Explain the process of administering a small bowel study

Answer 56

With the oral method the patient drinks the barium suspension and a series of timed radiographs follows its progress through the small bowel Enteroclysis is the injection of nutrient or medicinal liquid into the small bowel using a special catheter with a stiff wire guide is inserted through the mouth or nose and advanced to the distal portion of the duodenum

Question 57

Process of creating and maintaining an area completely free of pathogens

Answer 57

Surgical asepsis

Question 58

5 methods of sterilization

Answer 58

``` Chemical Autoclave Gas Gas plasma Dry heat ```

Question 59

Involves immersion and soaking of clean objects in a germicidal bath Effectiveness depends on solution strength, temperature and immersion time Less satisfactory due to contamination not being easily detectable Kills microorganisms but not spores

Answer 59

Chemical sterilization